There are many factors to consider when putting together a birth plan, including whether or not you feel comfortable with the use of anesthesia. While risks and serious complications must be considered, a new study has found that those risks might not be as common some mothers may think.
Epidurals, which are used by about 50% of mothers who give birth in a hospital, are local anesthetics. Delivered through a catheter placed in the back, the pain relieving effects of the drugs are felt immediately. However, complications can be serious:
- High neuraxial block – an unexpected high level of anesthesia that develops in the nervous system
- Respiratory arrest during labor and delivery
- Unrecognized spinal catheter – an undetected infusion of anesthetic through an accidental puncture of an outer layer of the spinal cord membrane.
But a recent study, led by Dr. Robert D’Angelo, of Wake Forest University School of Medicine in North Carolina, found these complications are rare, occurring only in about 1 out of every 3,000 births. Published in the journal Anesthesiology, the study used data from the Society for Obstetric Anesthesia and Perinatology’s (SOAP’s) Serious Complication Repository (SCORE) project. This large database captures delivery statistics and their complications.
In all, more than 257,000 mothers were given some form of anesthesia (spinal, general, or epidural) between 2004 and 2009. A total of 157 complications were reported. Only 85 of them were linked to the anesthesia – 1 in 4,336 deliveries resulted in high neuraxial block, 1 in 10,042 resulted in respiratory arrest, and 1 in 15,435 resulted in unrecognized spinal catheter.
“We were extremely pleased to find that serious complications such as bleeding, infection, paralysis and maternal death were extremely rare,” Dr. D’Angelo told Medical News Today. “However, since many complications can lead to catastrophic outcomes, it is important that anesthesiologists remain vigilant and prepared to rapidly diagnose and treat any complication, should it arise.”
Though unable to accomplish their original goal (identifying risk factors of complications to create formal practice advisories and guidelines could be created) due to the occurrences of complications being so rare, researchers do believe that their research can be used to guide patient discussions regarding anesthesia risks.
In addition, the findings will be used to create a national obstetric anesthesia complication registry. This will ensure that anesthesiologists are alerted when complications occur, and it will help in creating new materials for patient safety.
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